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Management of Symptoms of Allergic Rhinitis by Panchakarma Therapy: Concept and Application

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Background: Allergic Rhinitis is an inflammatory disorder of the nasal mucosa; common symptoms include nasal congestion, sneezing, rhinorrhea, nose itching, etc. Effective management of this disease, in short duration of time, is still a challenge. As per the classical texts of Ayurveda, the disease that resembles the symptoms associated with allergic rhinitis is Vataja Pratishyaya; Nasya procedure of Panchakarma therapy has shown encouraging results in managing its symptoms. ---------- Methodology: Panchakarma therapy was administered for 13 days to a male patient suffering from allergic rhinitis and associated ailments. According to Ayurveda, this disease is associated with the imbalance of Kapha and Vata doshas. Hence, Kapha and Vata pacifying therapeutic procedures and herbal medicines, that also provide nourishing effect to the respiratory system, were used. Later, patient took raw Haridra (Curcuma longa) for self-management of disease at home. ---------- Results: The patient experienced significant reduction in sneezing episodes, from about 150 per day to about 20 per day; relief in heaviness in the head region; and, complete relief in itching in nose and throat. Overall, the patient reported a good experience. In a followup taken after about one and a half years, the patient reported complete relief in sneezing episodes and heaviness in the throat, as well as non-recurrence of the earlier condition. ---------- Conclusion: Panchakarma Therapy showed encouraging results with regards to the management of the symptoms associated with allergic rhinitis and associated ailments, in a short duration of time. ---------- Keywords -- Allergic Rhinitis, Vataja Pratishyaya, Panchakarma, Ayurveda, Nasya, Herbal Medicine ---------- Published in -- Ayurveda evam Samagra Swasthya Shodhamala. 2019;1(1):4. ---------- Available Online @ https://sites.google.com/dsvv.ac.in/shodhamala-dahh/asssm11/asssm114
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Ayurveda evam Samagra Swasthya Shodhamala 2019;1(1):4
Management of Symptoms of Allergic Rhinitis by Panchakarma Therapy:
Concept and Application
Alka Mishra1, Lalima Batham1, Saurabh Mishra2,*
1Department of Ayurveda and Holistic Health, Dev Sanskriti Vishwavidyalaya, Gayatrikunj-
Shantikunj, Haridwar, Uttarakhand, India
2Dev Sanskriti Vishwavidyalaya, Gayatrikunj-Shantikunj, Haridwar, Uttarakhand, India
*Corresponding Author: Saurabh Mishra - Email: sau.dsvv@gmail.com
Cite this research article as follows:
Mishra A, Batham L, Mishra S. Management of symptoms of allergic rhinitis by
panchakarma therapy: concept and application. Ayurveda evam Samagra Swasthya
Shodhamala. 2019;1(1):4. [cited date]. Available from:
https://sites.google.com/dsvv.ac.in/shodhamala-dahh/asssm11/asssm114
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Published by:
Department of Ayurveda and Holistic Health
Dev Sanskriti Vishwavidyalaya
Gayatrikunj-Shantikunj, Haridwar - 249411
Uttarakhand, India
Email: dahh@dsvv.ac.in
Mobile: +91 9258360953, +91 8954890390
Website: http://www.dsvv.ac.in/dahh
1
Abstract
Background: Allergic Rhinitis is an inflammatory disorder of the nasal mucosa; common
symptoms include nasal congestion, sneezing, rhinorrhea, nose itching, etc. Effective
management of this disease, in short duration of time, is still a challenge. As per the classical
texts of Ayurveda, the disease that resembles the symptoms associated with allergic rhinitis is
Vataja Pratishyaya; Nasya procedure of Panchakarma therapy has shown encouraging results
in managing its symptoms.
Methodology: Panchakarma therapy was administered for 13 days to a male patient suffering
from allergic rhinitis and associated ailments. According to Ayurveda, this disease is
associated with the imbalance of Kapha and Vata doshas. Hence, Kapha and Vata pacifying
therapeutic procedures and herbal medicines, that also provide nourishing effect to the
respiratory system, were used. Later, patient took raw Haridra (Curcuma longa) for self-
management of disease at home.
Results: The patient experienced significant reduction in sneezing episodes, from about 150
per day to about 20 per day; relief in heaviness in the head region; and, complete relief in
itching in nose and throat. Overall, the patient reported a good experience. In a followup
taken after about one and a half years, the patient reported complete relief in sneezing
episodes and heaviness in the throat, as well as non-recurrence of the earlier condition.
Conclusion: Panchakarma Therapy showed encouraging results with regards to the
management of the symptoms associated with allergic rhinitis and associated ailments, in a
short duration of time.
Keywords: Allergic Rhinitis, Vataja Pratishyaya, Panchakarma, Ayurveda, Nasya, Herbal
Medicine
2
1. Introduction
Allergic Rhinitis is an inflammatory disorder of the nasal mucosa caused by allergic
sensitizaton to airborne allergens; it is characterized by nasal congestion, rhinorrhea,
sneezing, itching of the nose and/or post-nasal discharge [1-10]. These symptoms often cause
sleep disturbance, fatigue, depressed mood, etc., and thus have a major impact on the patient's
quality of life and productivity [1-3,5,8-10]. Almost 20%-30% of the population is affected
by this disease [1,2,8,10].
Therapeutic interventions conventionally employed for relieving the symptoms
associated with allergic rhinitis include allergen avoidance, oral antihistamines, intranasal
corticosteroids, allergen immunotherapy, etc. [3,5,7-9]. Although these interventions are
effective, yet there are various shortcomings such as occurrence of side-effects [7,11,12],
about 60% of the affected population not responding adequately to antihistamines and
intranasal corticosteroids [5,10], etc. Hence, there is a definite need to look for other effective
therapies for patients suffering from allergic rhinitis.
According to Ayurveda, a healthy human body is supposed to have a relatively stable
equilibrium (congenial homeostasis) of Dosha (psycho-biological rhythm - Vata, Pitta,
Kapha), Dhatu (body tissues and their nourishing elements) and Mala (excreta) [13,14];
Acharya Sushruta defines health as an equilibrium of Dosha (psycho-biological rhythm),
Agni (digestion and metabolism), Dhatu (body tissues and their nourishing elements),
Malakriya (excretory function), as well as the well being of soul, senses and mind [13,14].
Imbalance in this equilibrium leads to disease, and the aim of the therapy is to restore this
balance [14]. Treatment of disease involves procedures for purifying the biological system by
removing the vitiated elements from the entire body, and thus causing disease prevention, as
well as health promotion [3,13-16].
As per the classical texts of Ayurveda, the disease that resembles the symptoms
associated with Allergic Rhinitis is Vataja Pratishyaya [3,17,18]; these symptoms include
Tanu Nasa Srava (rhinorrhea), Shirashoola (headache), Kshavathu (sneezing), etc. The
concept of allergy is described under 'Asatmyaja Vyadhi', and its causes are hereditary,
Viruddhahara (related with food allergens), Dushivisha (leading to blood vitiating disorders
like Kitibha (psoriasis), etc.) and Ritu Sandhi (environmental factors, i.e. when proper
seasonal regimen is not followed) [17,18]. Pratishyaya is described as one of the most
important diseases related to nose (Nasaroga), wherein the vitiation of Vata and Kapha
doshas at the root of the nose, produces a secretion that flows down through the nose [3].
Thus, Vataja Pratishyaya primarily involves the vitiation of the Vata and Kapha doshas.
According to Ayurveda, the treatment of Vataja Pratishyaya must simultaneously
address the vitiation of both the Vata and Kapha doshas; shodhana (purificatory) and shamana
(pacifying) therapies have been recommended in this regard [17]. Panchakarma is a
purificatory Ayurvedic procedure, which includes Snehan (oleation) and Swedan (sudation) as
Poorva Karma (pre-procedures); Vaman (therapeutic emesis), Virechan (therapeutic
purgation), Anuvasana Basti (oil enema), Asthapana Basti (decoction enema) and Nasya
(nasal insuffolation) as Pradhan Karma (main-procedure); and, Sansarjan Kram (graduated
diet) as Paschat Karma (post-procedure) [19].
Nasya (nasal insuffolation) procedure of Panchakarma has been used for the treatment
of Vataja Pratishyaya (Allergic Rhinitis) with encouraging results [3,17,18], wherein, Modha
et al. (2009) [18] administered Shunthi Taila Nasya, along with internal drug Shuddha
Haridra (purified Curcuma longa) to patients of allergic rhinitis; Bhakti et al. (2009) [17]
administered Pippalyadi Taila Nasya, along with oral drug Haridra Khanda to patients of
allergic rhinitis; and, Kumar et al. (2014) [3] administered Anu Taila Pratimarsha Nasya to
patients of allergic rhinitis. Basti is another procedure of Panchakarma therapy, which is
considered one of the best treatments for Vata related disorders [20]. Thus, Nasya and other
3
procedures of Panchakarma therapy can be useful in the management of symptoms associated
with allergic rhinitis.
A case report about a male patient, who was suffering from allergic rhinitis, as well as
other associated ailments, is being presented here. He visited the Out Patient Section of the
Department of Ayurveda and Holistic Health at Dev Sanskriti Vishwavidyalaya, Haridwar,
and as is normally the case under most practical situations, he wanted relief in all the
complaints in a limited time frame. In view of the above discussion, short term Panchakarma
treatment was administered to the patient, and the effectiveness of the same is being
presented in this article.
2. Methods
2.1 Case Report
A 36 year old male patient (height 157 cm, weight 67 kg) came to the Out Patient
Section of the Department of Ayurveda and Holistic Health (DAHH) at Dev Sanskriti
Vishwavidyalaya, Haridwar in August 2017. He had deviated nasal septum towards left side
(DNS (L)). He had been advised Septoplasty, but he did not do it. He was suffering from
symptoms of allergic rhinitis since about two years. The details of his medical history and the
complaints at the time of the visit are as follows:
Left nostril was partially blocked
Sneezing episodes for up to 3 to 4 hours in the morning time - felt itching in the nose
with multiple episodes of sneezing - about 150 to 200 sneezes every day
Sometimes the sneezing continued the entire day
Mucus used to stick in the throat; there was heaviness in the throat
Severe heaviness in the head region
Pathological investigations (dated about two and half months prior to this visit) gave an
AEC (Absolute Eosinophil Count) value of 630 cells/mm3 and a DLC Eosinophils value of
7%, both of which were above the normal range. The patient had no past history of diabetes
mellitus, hypertension, ischemic heart disease, hypothyroidism.
Based on the above mentioned medical history and further discussion with the doctor,
the diagnosis for the patient included deviated nasal septum towards left side, with Allergic
Rhinitis, with Eosinophilia.
2.2 Therapeutic Intervention
As mentioned above, the patient was suffering from allergic rhinitis (Vataja
Pratishyaya), which primarily involves the vitiation of the Vata and Kapha doshas.
Furthermore, as the patient had come to the Out Patient Section, and had limited time to take
the therapy, the therapeutic intervention was planned accordingly.
Informed consent was obtained from the patient before the start of the therapy.
The therapeutic intervention included Panchakarma therapy, which was administered to
the patient for 13 days, and is listed in Table 1. Botanical names of medicinal plants used in
the present study are given in Table 2.
4
Table 1: Therapeutic intervention administered to the patient over a period of 13 days. The
letter 'Y' indicates that the therapeutic procedure mentioned in that row, was administered on
that day.
Therapeutic Intervention
Day
1 2 3 4 5 6 7 8 9 10 11 12 13
Deepan Pachan Drug (Shankha Vati + Sitopaladi
Churna)
Y Y Y Y Y
Abhyangam (Sarvanga) (Full Body Massage) with
Sahacharadi Taila + Karpooradi Taila +
Dhanvantar Taila + Saindhav Lavan
Y Y Y Y Y Y Y Y Y Y
Abhyangam (Ekanga) (Local Massage) of the above
oils
Y
Vashpa Sweda (Sarvanga) (Full Body Steam) of
Dashamoola kwatha and Erandamoola kwatha
Y Y Y Y Y Y Y Y Y Y
Nadi Sweda (Local Steam) of Dashamoola kwatha
and Erandamoola kwatha
Y
Koshtha Shuddhi through Virechan Vati (Myrolax)
+ Avipattikar Churna
Y
Basti - Anuvasana with Sahacharadi Taila Y Y Y
Basti - Asthapana with kwatha of Dashamoola +
Erandamoola + Triphala + Vasa + Kantakari +
Bharangi + Yashtimadhu + Bala + Giloy
Y Y
Nasya with Shadbindu Taila (numbers represent the
number of drops in each nostril) (pre-procedure -
face Abhyangam with Karpooradi Taila)
6 6 7 7 8 8 9 9
Shirodhara with Til Taila Y Y Y
Kwatha of Dashamoola + Bala + Giloy + Nirgundi
+ Rasna + Nagarmotha + Vasa + Kantakari +
Bharangi + Yashtimadhu + Vacha (sweet)
Y Y Y Y Y Y Y Y Y Y Y
5
Table 2: Botanical names of medicinal plants used in the present study.
Common Name Botanical Name
Dashamoola (Roots of ten plants)
(a) Laghu Panchamoola (roots / whole plant of 5 shrubs)
Shalaparni Desmodium gangeticum
Prishnaparni Uraria picta
Brihati Solanum indicum
Kantakari Solanum xanthocarpum
Gokshuru Tribulus terrestris
(b) Brihat Panchamoola (roots of 5 trees)
Bilva Aegle marmelos
Agnimanth Clerodendrum phlomidis
Gambhari Gmelina arborea
Shyonak Oroxylum indicum
Patala Stereospermum suaveolens
Triphala (combination of 3 fruits)
Amalki Emblica officinalis
Haritaki Terminalia chebula
Vibhitaki Terminalia bellirica
Bala Sida cordifolia
Bharangi Clerodendrum Serratum
Erandamoola root of Ricinus communis
Giloy Tinospora cordifolia
Nagarmotha Cyperus rotundus
Nirgundi Vitex negundo
Rasna Pluchea lanceolata
Vacha (sweet) Acorus Calamus
Vasa Adhatoda vasica
Yashtimadhu Glycyrrhiza Glabra
As shown in Table 1, the patient was given Deepan Pachan drugs on the first 5 days;
Shankha Vati and Sitopaladi Churna were used. Ingredients of Sitopaladi Churna commonly
include Saccharum officinarum (sugar candy), Bambusa arundinacea (siliceous concretion),
Piper longum (dried fruit), Elettaria cardamomum (dried seed), and Cinnamonum
zeylanicumm (stem bark) [21]. Ingredients of Shankha Vati commonly include Shankha
bhasma (Conch Shell), Hingu (Ferula fietida Regel.), Vatsanabha (Aconitum Chasmantum
Staff.ex. Holmes), Trikatu, Kshara, Lavana, etc. [22].
The snehan (oleation) therapies administered to the patient were as follows:
Abhyangam (Sarvanga) (Full Body Massage) was given on day 1, from day 3 to day
6, and from day 9 to day 13
6
Abhyangam (Ekanga) (gentle Local Massage) was given on day 8
Among the oils used for Abhyangam, the ingredients of Sahacharadi Taila commonly
include Sahachara (Barleria prionits), Devadaru (Cedrus deodara) and Shunthi (Zingiber
officinale Roscoe.) [23]; those of Karpooradi Taila commonly include Ajamoda
(Trachyspermum ammi), Karpoor (Cinnamomum camphorum) and Coconut oil [24]; and,
Dhanvantar Taila is a polyherbal formulation consisting of more than 40 ingredients, with Til
Taila as base [25].
The snehan therapy was followed by swedan (sudation) therapy. The swedan therapies
administered to the patient were as follows:
Vashpa Sweda (Sarvanga) (Full Body Steam) was given on day 1, day 3 to day 6, and
day 9 to day 13
Nadi Sweda (Local Steam) was given on day 8
The snehan and swedan therapies are the purva karma (pre-procedures) for the Basti
treatment as pradhan karma (main procedure).
Before starting the Basti treatment, Virechan vati - Myrolax tablet (Nagarjuna
company) along with Avipattikar churna were given to the patient on day 7 for low-grade
purification of gastro-intestinal tract (Koshtha Shuddhi). (Note: As Koshtha Shuddhi was
done on day 7, hence full body massage was not done on the next day)
Basti treatment was given to the patient for five days, which included giving
Anuvasana Basti (oil enema) and Asthapana Basti (decoction enema) on alternate days, i.e.
Anuvasana Basti on days 9, 11 and 13, and Asthapana Basti on days 10 and 12. Anuvasana
Basti [26] and Asthapana Basti [20] are the process of drug administration through the rectal
route, wherein oil or other oleaginous substance is the major content in case of Anuvasana
Basti, while medicated decoction is the major part in Asthapana Basti. Total of 3 Anuvasana
and 2 Asthapana Basti were given to the patient.
Nasya (nasal insuffolation), with Shadbindu Taila (numbers given in Table 1 represent
the number of drops in each nostril), was administered to the patient on day 1, from day 3 to
day 6, and from day 8 to day 10. The pre-procedure (purva karma) of Nasya involves doing
massage (abhyangam) and hot fomentation (swedan) on the face and head [27-29]. This is
followed by the main-procedure (pradhan karma) of Nasya, wherein the medicine is
administered through the nasal route by pouring it, drop by drop, in both the nostrils [28].
Shadbindu Taila commonly includes Til Taila (Sesamum indicum L.), Bhringa (Eclipta alba
(L.) Hassk.), Aja Paya (goat milk), Eranda (Ricinus communis L.), Tagara (Valeriana
wallichii DC.), Shatahva (Anethum sowa Roxb.), Jivanti (Leptadenia reticulata [Retz.] Wight
and Arn.), Rasna (Pluchea lanceolata), Vidanga (Embelia ribes Burm.f.), Yashti (Glycyrrhiza
glabra L.), Shunthi (Zingiber officinale Roscoe.), and Saindhava Lavana (Rock salt) [30].
Shirodhara of Til Taila was administered to the patient on the last three days of the
therapy. The procedure of Shirodhara involves continuous pouring of medicated liquid on the
forehead of the patient, which creates specific pressure and vibration on the forehead [31,32].
The patient was also given a Kwatha (decoction) of Vata pacifying (Vata-shamak) and
tissue nourishing (Vrinhan) herbal medicines on all the days of the therapy except day 2 and
day 7.
Some other associated methodologies that were administered along with the above
therapeutic procedure are as follows.
Dietary restrictions were prescribed, which included not taking Vata and Kapha
aggravating diet. It was advised to take only warm water to drink, and for bathing etc. Other
7
behavioral regimen were also prescribed, such as, do not indulge in fear, anxiety, stress,
anger, and any other negative thought; do not roam around too much; do not obstruct your
natural urges like hunger, thirst, sleep, yawning, tear, etc. Try to keep your mind calm and
happy, try to be silent, go early to bed and wake up early in the morning.
The doctor regularly talked to the patient about his condition, and provided both
clinical and motivational guidance, i.e. did regular counseling with positive thoughts. Gayatri
Mantra was played continuously during the therapy.
3. Results
In this case report, the outcomes were assessed in a qualitative (subjective) manner
based on the doctor's pre and post examination, and, patient's experiential feedback, as given
in Table 3.
Table 3: Pre Therapy and Post Therapy Observations
Pre Therapy Observation Post Therapy Observation
Severe heaviness in the head region 90% improvement
Sneezing episodes for up to 3 to 4 hours in the
morning time - about 150 to 200 sneezes every
day - sometimes sneezing continued the entire day
Significant reduction in sneezing episodes -
only about 15 to 20 sneezes in the entire day -
no problem in the morning time
Severe itching present in the nose and throat
region
100% improvement in the itching
Heaviness in the throat still present
Left nostril partially blocked During breathing, there was difficulty in taking
breath from left side
Overall, the patient had a good experience after
taking the therapy
Before the start of the therapy the patient reported severe heaviness in the head region.
After 13 days of the Panchakarma treatment, the patient reported about 90% improvement in
this complaint.
Before the start of the therapy, the patient reported sneezing episodes for up to 3 to 4
hours in the morning time, with about 150 to 200 sneezes every day, and sometimes sneezing
continued the entire day. After the therapy, the patient reported significant reduction in
sneezing episodes, with only about 15 to 20 sneezes in the entire day, and no problem in the
morning time.
Before the start of the therapy, the patient reported the presence of severe itching in the
nose and throat region. After the therapy, there was complete relief in itching, but heaviness
in the throat was still present.
Before the start of the therapy, the left nostril was partially blocked due to DNS. The
patient continued to experience difficulty in taking breath from left nostril after the therapy.
Overall, the patient reported a good experience after taking the therapy.
3.1 Followup
About one and a half years after taking the Panchakarma therapy, a verbal feedback
8
was taken from the patient over telephone, in March 2019, regarding his current condition.
The patient reported that he was doing well and did not experience a recurrence of his earlier
condition. There was complete relief in sneezing episodes and heaviness in the throat. All this
while, he had been taking raw Haridra (Curcuma longa) as supportive care.
4. Discussion
A case report about a male patient, who was suffering from allergic rhinitis, as well as
other associated ailments, is being presented here. Since allergic rhinitis (Vataja Pratishyaya)
is primarily associated with the vitiation of the Vata and Kapha doshas, Panchakarma therapy
was administered to the patient accordingly.
The results given in Table 3 indicate that Panchakarma Therapy gives encouraging
outcomes, even in short duration. This result may be attributed to the therapeutic action of
various Ayurvedic procedures administered to the patient.
To begin with, Deepan Pachan medicines are administered for enhancing the digestive
fire [33,34], for digestion of the Ama Dosha (undigested toxins of the body that are
responsible for the blockage of micro-channels, i.e. srotas), as well as for the preparation of
the body for next therapies. Shankha Vati is beneficial in digestion [22]. The ingredients of
Sitopaladi Churna also have Kapha pacifying properties [35,36].
The snehan (oleation) (Abhyangam - massage) and swedan (sudation) (Vashpa Sweda -
steam) therapies are the purva karma (pre-procedures) for the pradhan karma (main
procedures) described above; these cause softening and liquifying of the vitiated Doshas [27],
which can then be removed from the body through the pradhan karma (main procedure).
The oils used in snehan therapy have snigdha (unctuous), guru (heavy) and mridu (soft)
properties, which are opposite to the properties of Vata; hence Abhyangam reduces the
vitiated Vata [37]. Also, in the present study, the oils and other ingredients chosen for
Abhyangam were such, which balance the Kapha dosha as well; Saindhav Lavan has Kapha
pacifying properties [35,36], ingredients of Dhanvantar Taila have Vata pacifying properties
[25,35,36,38], and, ingredients of Sahacharadi Taila [39] and Karpooradi Taila [35,36] have
both Kapha and Vata pacifying properties. Besides balancing the vitiated Doshas, the oils also
provide nourishing effect (Vrinhan) to the degenerative tissues.
Swedan has actions like stambhaghna (relieves stiffness), sweda-karak (creates
perspiration), and, gauravaghna (cures heaviness) [37].
Nasya (nasal insuffolation) was administered to the patient with Shadbindu Taila. The
pre-procedure (purva karma) of Nasya (massage and hot fomentation on the face and head)
causes the softening and liquifying of the vitiated Doshas [27-29]. The vasodilation caused by
the pre-procedure is supposed to increase the permeability of the blood vessels, which makes
the absorption of the medicine faster [27]. The main-procedure (pradhan karma) of Nasya
involves administering the medicine through the nasal route, by pouring it, drop by drop, in
both the nostrils [28].
Nasya primarily affects the urdhvajatrugata pradesha (supra-clavicular region) [28,38].
According to Acharya Vagbhatta, nose is one of the most convenient routes to convey
medicinal effects to the cranial cavity [28]. According to Acharya Charaka, nasya drug
usually acts through absorption by the Shringataka marma (a vital spot in the head region
situated at the site of the union of the nerves, supplying to the nose, ears, eyes, and tongue);
after absorption, the medicine acts on the diseases of the respiratory system, shoulder, neck,
etc., and the vitiated Doshas are expelled from the head region [28]. Thus, the administered
medicine moves up to the Shringataka marma, spreads all over the head, channels of eyes,
ears, nose and throat, and removes vitiated Doshas from there [28,38].
Nasya was done with Shadbindu Taila, whose ingredients have beneficial effects with
9
regards to balancing the vitiated Vata and Kapha doshas, as well as providing strength and
nourishing effect (Vrinhan) to the respiratory system [35,36]; Rasna has Vata pacifying and
rejuvenating properties [35,36], Shunthi has Kapha and Vata pacifying properties [18],
Saindhav Lavan has Kapha pacifying properties [35,36].
The Koshtha Shuddhi procedure does a low-grade purification of the gastro-intestinal
tract, and prepares the body for the Basti treatment.
Basti is one of the best treatment in the case of Vata disorders [20], as stated by
Acharya Charak (Vastirvaataharaannaam) {Charak Samhita - Sutra Sthan 25/40} [15,16].
During the treatment, 3 Anuvasana Basti (oil enema), and 2 Asthapana Basti (decoction
enema) were administered to the patient. Anuvasana Basti (oil enema) nourishes the dhatus,
promotes strength and cures Vata related diseases; Asthapana Basti (decoction enema)
cleanses the colon and cures Vata related diseases [37]. Also, the herbal medicines used for
Basti in the present study, have Kapha pacifying properties as well [35,36]; hence, Basti must
have helped in balancing both the vitiated Vata and Kapha Doshas.
Since the patient reported severe heaviness in the head region, hence Shirodhara was
administered to the patient. Shirodhara creates specific pressure and vibration on the
forehead, with beneficial therapeutic effect in terms of relieving stress, anxiety, etc. [31,32].
The Til Taila used for Shirodhara has Vata pacifying properties [31].
The patient was also given a Kwatha (decoction) of Kapha and Vata pacifying, as well
as tissue nourishing (Vrinhan) herbs [35,36], which must have contributed to the observed
therapeutic benefits.
Almost daily the doctor talked to the patient about his condition, and provided both
clinical and motivational guidance; the purpose was to instill confidence in the patient that his
condition can be improved, and he has to himself take responsibility of bringing about this
change by diligently following the prescribed treatment and guidelines.
Gayatri Mantra was played continuously during the therapy; Gayatri Mantra causes
beneficial effects with regards to various physical and mental conditions like attention,
concentration, etc. [40-45]. The patient must also have benefited from the spiritually charged
environment of Dev Sanskriti Vishwavidyalaya, Haridwar.
During Panchakarma Therapy, it is advised to avoid 'Ashta-Maha-Doshkar-Bhav' (eight
types of behavioral and dietetic practices that cause obstructions in micro-channels (srotas)
leading to aggravation of the diseases) so that better results can be observed. The following of
these practices must also have contributed in providing the observed relief.
The above discussion reveals that since the major complaints of the patient were
associated with Kapha and Vata imbalance, hence, the therapeutic procedures administered to
the patient had Kapha and Vata pacifying, as well as tissue nourishing (Vrinhan) effects,
which must have caused the amount of relief experienced by the patient in such a short
duration of therapy. Also, in place of using a single therapy, a combination of different
therapeutic procedures, along with multiple herbs, were used, in order to achieve
simultaneous management of the symptoms associated with multiple ailments.
Although the results are qualitative in nature, yet the degree of benefit attained in
simultaneously addressing multiple complaints is noteworthy, especially considering the fact
that the patient was an Outdoor Patient, had genuine limitations in following the dietary
restrictions, and the therapy was administered for quite short duration.
With regards to the long term impact of the therapeutic procedure, in a followup taken
about one and a half years after taking the above therapeutic procedure, the patient reported
that he was doing well and did not experience a recurrence of his earlier condition. There
was complete relief in sneezing episodes and heaviness in the throat. All this while, he had
been taking raw Haridra (Curcuma longa) as supportive care, which has blood purifying
properties, and is also Kapha and Vata Shamaka (pacifying) [18]. This long-term non-
10
recurrence of the disease symptoms after the above therapeutic procedure is an extremely
encouraging outcome, and illustrates the effectiveness of this therapeutic procedure in long-
term management of the symptoms associated with allergic rhinitis and associated ailments.
Further in-depth quantitative study would definitely be worthwhile to establish the
mode of operation of the administered therapeutic procedure in the light of modern scientific
understanding.
5. Conclusion
Panchakarma Therapy was administered to a male patient for the management of the
symptoms associated with allergic rhinitis and associated ailments. Various therapeutic
procedures were administered to the Out Patient section patient over a period of 13 days.
Qualitative analysis showed encouraging results, with the patient experiencing relief in
various symptoms including sneezing episodes, heaviness in the head region, and, itching in
the nose and throat region, in a short duration of time. The long term effects of the therapeutic
procedure were also found to be encouraging with the patient reporting complete relief in
sneezing episodes and heaviness in the throat, as well as non-recurrence of the earlier
condition, after about one and a half years of taking the therapy (the patient took raw Haridra
(Curcuma longa) as supportive care during this time).
Acknowledgements
Authors would like to acknowledge the subtle guidance of their spiritual guide,
Revered Pandit Shriram Sharma Acharya, who founded the organization All World Gayatri
Pariwar (www.awgp.org). The authors thank the faculty and staff of the Department of
Ayurveda and Holistic Health and the Department of Complementary and Alternative
Medicine at Dev Sanskriti Vishwavidyalaya, Haridwar for their support in conducting this
study.
Compliance with ethical standards: Informed consent was obtained from the patient before
the start of the therapy.
Conflict of interest: The authors declare that they have no conflict of interest.
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